Inflammatory biomarkers as predictors of prognosis in patients after transcatheter aortic valve implantation.

BACKGROUND

The expanding role of transcatheter aortic valve implantation (TAVI) highlights the need to identify factors influencing long-term outcomes. Systemic inflammatory response syndrome (SIRS) is a frequent post-procedural event that may adversely affect prognosis. Measurement of inflammatory biomarkers may improve the understanding of underlying mechanisms and refine patient risk stratification.

METHODS

This single-center, prospective cohort study, enrolled 62 consecutive patients undergoing TAVI, who were followed for up to 5 years. Blood samples were collected before TAVI, at 24 h and 3-6 months post-procedure. Changes in biomarker levels, predictors of SIRS, and inflammatory predictors of long-term outcomes were analyzed.

RESULTS

SIRS developed in 45% of patients. Significant temporal changes were observed in hs-CRP, TNF-α, sST2/IL-33, IL-10, and IL-2 levels, irrespective of baseline or procedural characteristics. The development of SIRS was associated with a higher risk of all-cause mortality or unplanned hospitalization at 5 years (HR 3.07, 95% CI 1.57-6.00; p = 0.001). Baseline hs-CRP (HR 1.21, 95% CI 1.09-1.35; p < 0.001) and IFN-γ (HR 1.22; 95% CI 1.09-1.36; p < 0.001) levels were predictive of adverse outcomes. In multivariable Cox analysis, these associations remained, though findings should be interpreted cautiously given the limited sample size.

CONCLUSIONS

SIRS is a common post-TAVI phenomenon and may be linked to long-term outcomes. Elevated pre-procedural hs-CRP and IFN-γ levels were associated with higher risk for adverse events, suggesting they may serve as exploratory biomarkers for risk stratification in this population.